Imperial College London
Alternate

ProfessorGeorgeHanna

Faculty of Medicine, Department of Surgery & Cancer

Head of Department of Surgery and Cancer
 
 
 
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Contact

 

+44 (0)20 7594 3396g.hanna

 
 
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Assistant

 

Ms Aoibheann Byrne +44 (0)20 7594 3396

 
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Location

 

Block B Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Leff:2015:10.1002/bjs.9970,
author = {Leff, DR and Petrou, G and Mavroveli, S and Bersihand, M and Cocker, D and Al-Mufti, R and Hadjiminas, DJ and Darzi, A and Hanna, GB},
doi = {10.1002/bjs.9970},
journal = {British Journal of Surgery},
pages = {207--217},
title = {Validation of an oncoplastic breast simulator for assessment of technical skills in wide local excision.},
url = {http://dx.doi.org/10.1002/bjs.9970},
volume = {103},
year = {2015}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Simulation enables safe practice and facilitates objective assessment of technical skills. However, simulation training in breast surgery is rare and assessment remains subjective. The primary aim was to evaluate the construct validity of technical skills assessments in wide local excision (WLE). METHODS: Surgeons of different grades performed a WLE of a 25-mm palpable tumour on an in-house synthetic breast simulator. Procedures were videotaped (blinded), reviewed retrospectively, and independently rated against a procedure-specific global rating scale by two consultant breast surgeons. Specimen radiographs were obtained and the macroscopic distance from the 'tumour' edge to the resection margin was recorded in four cardinal directions. Expert consensus was used to construct an Oncoplastic Deviation Score (ODS), assigning points for excessively wide (more than 10 mm) and, conversely, close (less than 5 mm) macroscopic margins. RESULTS: Thirty-four surgeons (12 consultant surgeons, 12 specialty trainees and 10 core trainees) participated in the study. Video-based rating scores varied hierarchically with operator expertise (P < 0·050). Inter-rater reliability was excellent (α ≥ 0·80, P < 0·050 for all scales), and inter-rater agreement was moderate (κ = 0·132-0·361, P < 0·050 for all scales). Statistically significant differences were observed on pairwise comparisons between each grade of surgeon in scores for 'exposure', 'skin flap development', 'glandular remodelling', 'skin closure' and 'final product review' (P < 0·050). Consultants received significantly fewer ODS points than specialty trainees (P = 0·012) and core trainees (P = 0·028). Compared with experts (median 9·0 mm), wider margins were observed amongst specialty trainees (median 12·0 mm) and narrower margins amongst core trainees (median 7·1 mm) (P = 0·001). CONCLUSION: Video r
AU  - Leff,DR
AU  - Petrou,G
AU  - Mavroveli,S
AU  - Bersihand,M
AU  - Cocker,D
AU  - Al-Mufti,R
AU  - Hadjiminas,DJ
AU  - Darzi,A
AU  - Hanna,GB
DO  - 10.1002/bjs.9970
EP  - 217
PY  - 2015///
SN  - 1365-2168
SP  - 207
TI  - Validation of an oncoplastic breast simulator for assessment of technical skills in wide local excision.
T2  - British Journal of Surgery
UR  - http://dx.doi.org/10.1002/bjs.9970
VL  - 103
ER  -
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